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Prone Ventilatory Therapy in Critically Ill Cancer Patients

  • Alex PearceEmail author
  • Rebecca E. Sell
Reference work entry

Abstract

Mortality in critically ill cancer patients requiring mechanical ventilation approaches 60%. When mechanical ventilation is required for severe hypoxemia and acute respiratory distress syndrome, mortality ranges from 70% to 100%, with worse outcomes in patients with hematologic malignancy and stem cell transplant. While overall mortality has improved with the use of lung protective strategies like low tidal volume ventilation and conservative fluid management, prone positioning has been shown to improve gas exchange and decrease ventilator-associated lung injury. By recruiting collapsed lung units and redistributing transpulmonary pressures, prone positioning is associated with improved hemodynamics, decreased organ dysfunction, and improved mortality. Observational studies and retrospective case series suggest that prone positioning may improve mortality in patients with cancer and ARDS but in practice may be underutilized.

Keywords

Acute lung injury Acute respiratory distress syndrome Prone position Critical care Malignancy 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of California San DiegoLa Jolla, San DiegoUSA
  2. 2.Division of Pulmonary and Critical CareUniversity of California San DiegoSan DiegoUSA

Section editors and affiliations

  • Yenny Cardenas
    • 1
  1. 1.Critical Care DepartmentUniversidad del Rosario Hospital Universitario Fundacion Santa Fe deBogotaColombia

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